Exhaled Nitric Oxide (FeNO)

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Factors Affecting FeNO Levels

Elevated FeNO
 Reduced FeNO
  • Airway infection--------
  • Allergic rhinitis
  • Nitrate-rich diet
  • Bronchodilator
  • Spirometric maneuvers
  • Exercise
  • Alcohol consumption
  • Bronchoconstriction
  • Ciliary dyskinesia
  • Pulmonary hypertension--------
  • Cystic fibrosis
  • Smoking
  • ICS therapy
factors_affecting_eno.png

Respiratory Infections

  • Increase eNO: Rhinoviral infections
  • Decrease eNO: Influenza, RSV, bacterial infections


Interpretation

ATS Guidelines (2011)


ATS_eno_interpretation.png


ATS_high_eno.png


ATS_low_eno.png



Aerocrine

eNO_values.png

Aerocrine_normal_levels.jpg




Management


National Jewish Consensus Statement

eno_management.png

Eosinophil-directed Asthma Treatment Strategy

Asthma Tx Strategy.png



References

Aerocrine eNO chart.pdf

National Jewish eNO consensus statement 2009.pdf

Chest-2010-Barnes-682-92.pdf

Exhaled Markers of Pulmonary Disease - AJRCCM 2001.pdf

Interpretation of Exhaled Nitric Oxide Levels - ATS 2011.pdf

Exhaled nitric oxide and blood eosinophilia- Independent markers of preventable risk - JACI 2013.pdf